Manager, Performance Analytics

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🕒 Julho 20

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $130.000 - $160.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

🦅 Patrocina Visto H1B

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Covera Health

51 - 200 funcionários

🏥 Saúde

⚕️ Seguro de Saúde

🤖 Inteligência Artificial

💰 $27.900.000 Series C em 2021-08

Healthcare • Healthcare Insurance • Artificial Intelligence

Na Covera, estamos comprometidos em garantir que assistência médica de alta qualidade seja mais do que apenas uma promessa. Por isso, estamos liderando o caminho na emergente ciência da qualidade, conectando prestadores de serviços e pagadores em sua busca conjunta para melhorar os resultados dos pacientes e a qualidade do atendimento. Ao enfrentar esse desafio, temos a capacidade de impactar milhões de vidas, elevando o padrão de cuidado em todo o país. Nosso foco inicial é a radiologia, onde um diagnóstico precoce e preciso tem um impacto profundo na jornada de cuidados subsequente do paciente. Através do nosso trabalho, que utiliza ferramentas baseadas em ciência clinicamente validada, estamos ajudando médicos a aprimorar seu atendimento, garantindo que os pacientes recebam o diagnóstico correto e capacitando o sistema de saúde a apoiar melhorias de qualidade em larga escala. Através de nossa plataforma de inteligência clínica, lançamos programas que ajudam as pessoas a acessarem o atendimento mais eficaz e fornecem aos médicos insights e ferramentas de qualidade movidas por IA para aprimorar seu atendimento. Atualmente, a Covera tem parceria com grandes empregadores, pagadores e organizações de saúde nos EUA, incluindo Walmart e Microsoft. E, com um pipeline que representa mais de 25% dos americanos segurados, estamos nos estágios iniciais de melhorar a qualidade do atendimento para todos os pacientes em todo o mundo. Em agosto de 2021, levantamos uma rodada de financiamento Série C de $25 milhões com a Insight Partners, uma das principais empresas globais de capital de risco e private equity que investe em empresas de alto crescimento que promovem mudanças transformadoras em suas indústrias.

Descrição

• Own the program’s analytics pipeline: intake and analysis of claims records, eligibility files, and MAO-004 reconciliation data across all clients. • Own care-gap identification: the analysis that determines which validated findings represent open, addressable gaps. • Own closure reconciliation on the program's vintage-cohort, MAO-004-evidenced measurement basis, including the monthly cohort measurement cycle and the collection-method distinctions (current eligibility vs. retrospective) that determine how cohorts are read. • Own billing reconciliation: studies-analyzed and per-unit program activity reconciled to invoiced volume by client and by practice, at a standard that survives client audit. • Build funnel instrumentation: stage-level conversion from finding identified, to shared with the physician, to acted on, to closed, so the program can see where value leaks rather than only its cumulative totals. • Deliver practice-level performance analysis: which practices are converting, which need education or intervention, and where concentration or volume volatility creates program risk. • Deliver the program’s baseline restatement on the vintage-cohort measurement basis and stand up the monthly measurement cycle aligned to CMS reconciliation windows in your first 90 days. • Document, standardize, and progressively automate the pipeline in partnership with Product and Engineering, so the program’s measurement survives any individual.

🎯 Requisitos

• Deep hands-on fluency with healthcare claims data structures: professional and institutional claim formats, diagnosis and procedure coding, member and provider identifiers, and how eligibility files join to claims. • Direct experience with healthcare regulatory and quality reporting: Medicare Advantage risk adjustment data, including MAO-004 files, strongly preferred; familiarity with CDI (clinical documentation integrity) reporting, encounter data, or similar plan-side reporting a strong plus. • Demonstrated ability to build and run analysis independently, from SQL queries against large datasets through Excel and pivot-table analysis to finished output: these are working skills you use daily, not skills you manage in others. • Rigor about correctness: your numbers appear on invoices and settle compensation and client performance conversations, and you treat that accordingly. • Hypothesis-driven by habit: you ask the relevant questions, form a view, test it, verify the result, and repeat. We will ask what you built, what changed as a result, and what failed. • Fluency with value-based care: risk arrangements, care-gap economics, and what closure means clinically and financially. • Comfort operating without a large team: this is a builder-operator seat in a scaling program, with strong executive support and high visibility.

🏖️ Benefícios

• Comprehensive medical plans - choose from three plans, including one with 100% of premiums covered for you and your dependents • Vision & Dental • Hybrid Time Off Policy (Flexible Time Off (FTO) Policy for exempt employees and Paid Time Off (PTO) Policy for non-exempt employees) • Sick days in accordance with your state law • 12 weeks of paid parental leave • 12 Fixed Holidays (company closed) • 5 Covera Days • 401(k) Retirement Plan • Annual Professional Development Stipend to invest in courses, books, or any other professional development related activity • Annual Wellness stipend for fitness, mental health or other wellness expenses

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